In the wake of heated criticism about lengthy wait times for veterans’ care at Veterans Health Administration hospitals, the U.S. Department of Veterans Affairs has moved to allow advanced-practice registered nurses (APRNs) to practice to their full authority without physician oversight and regardless of individual state law in VA facilities. Among the critics: President Donald Trump, who discussed the issue during his election campaign.
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The proposal, which drew 223,296 comments during the consideration process, excludes certified registered nurse anesthetists and is intended to make it easier for veterans to be seen by medical professionals, thus reducing the time they must wait to be seen for treatment. The final rule took effect Jan. 14.
“This preemptive rule increases access to care and reduces the wait times for VA appointments utilizing the current workforce already in place,” the VA said in its final rule implementing the policy, adding that the new policy will be especially beneficial in medically underserved areas.
The rule was strongly opposed by groups representing physicians, including the American Medical Association and the AUA.
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Last July, the AUA joined more than 100 state and federal medical societies on a letter initiated by the AMA opposing the draft rule and urging the VA to consider alternatives that focus on a team-based model of care rather than independent nursing practice.
“This is consistent with the AUA’s position and consensus statement on advanced practice providers being a part of a physician-led team,” the AUA said in a Policy and Advocacy Brief article posted online in early January. “The statement, in particular, was developed in conjunction with representatives from the Urological Association of Physician Assistants and the Society of Urologic Nurses and Associates,” the article noted.
The AUA will continue to work closely with the AMA to monitor the rule’s implementation, and that the AUA’s standing VA Workgroup is currently “dissecting the decision and formulating a response that can be shared with appropriate government officials,” the article said.